Introduction: Burnout in medical students is extensive and a critical issue. It is associated with increased rates of depression, suicide, and poor perception of the educational environment. Enhancing resilience, the ability to adapt well in the face of adversity, is a potential tool to mitigate burnout and improve medical student wellness. Methods: Our resilience curriculum consisted of facilitated workshops to cultivate resilience in medical students during their core clerkship rotations. This curriculum served as an introduction to the concept of resilience and taught skills to cultivate resilience and promote wellness. The sessions allowed for identification of and reflection on stressors in the clinical learning environment, including straining team dynamics, disappointment, and uncertainty. Educational sessions included resilience skill-building exercises for managing expectations, letting go of negative emotions, dealing with setbacks, and finding meaning in daily work. Associated materials included lesson plans for small-group facilitators, learner pre-and postcurriculum surveys, and a social media activity guide. Results: This curriculum was delivered to 144 clerkship students at two academic institutions over the 2017-2018 academic year. Sessions were well received by medical students, with the majority of students stating that the sessions should continue. The majority of attendees found the sessions valuable and learned new ways to approach challenges. Discussion: Students valued connecting with peers and feeling less alone through their participation. A challenge was constructing a setting conducive to comfortable reflection for all learners. Not all students found these sessions necessary. Sessions may have improved resilience levels.

Introduction Burnout in medical trainees is extensive and a critical issue. It is associated with increased rates of depression, suicide, and poor clinical performance. Enhancing resilience, the ability to adapt well in the face of adversity, is a potential tool to mitigate burnout and improve professional development. Our resilience curriculum consists of novel skill-building workshops to help programs cultivate resilience in their trainees. Methods This curriculum serves as an introduction for medical trainees and educators to the concept of resilience and teaches skills to help cultivate resilience and promote wellness. The sessions allow for identification of and reflection on stressful clinical events and consist of resilience-enhancing exercises, including setting realistic goals, managing expectations, letting go after medical errors, and finding gratitude. Through small-group reflection, the sessions also help participants discuss challenges with peers. This curriculum is intended for use with intern, junior, and/or senior residents and allows residency programs to address Accreditation Council for Graduate Medical Education milestones in the areas of professionalism, identification of system error, and advocating for system improvement. Materials include an introduction to resilience topics, guidelines for small-group facilitators, a learner precurriculum survey, and an evaluation form. Results Sessions were well received by interns. The majority of attendees felt more comfortable talking about burnout and medical errors and learned new ways to approach challenges. Discussion This resilience curriculum has been continued in the intern curriculum and has been presented at a national conference. Resilience training is an effective educational intervention to help trainees manage feelings of distress during residency training.

Background: Telehealth, especially the use of real-time video and phone visits in ambulatory care, is increasingly important in the wake of the COVID-19 pandemic. The current state of internal medicine (IM) interns' telehealth training at the start of residency is unknown. Objective: To characterize the attitudes, training, and preparedness of IM interns regarding the use of telehealth video and phone visits in ambulatory care. Methods: We conducted a cross-sectional survey of IM interns at four IM residency programs in the United States in 2020. Results: One hundred fifty-six surveys were analyzed (response rate 82%). Seventy-five percent of interns rated training in the use of real-time video and phone visits for ambulatory care as important or very important. The vast majority received no training (74%) or clinical experience (90% no prior video visits, 81% no prior phone visits) during medical school. More interns believed that primary care may be effectively delivered via video visits compared with phone visits (77% vs. 35%). Most interns (69%) missed clinical time during medical school due to the COVID-19 pandemic; 41% felt that the pandemic negatively affected their ambulatory care preparation. Overall, the majority of interns (58%) felt prepared for primary care; only 12% felt prepared to deliver primary care using either video or phone visits.Conclusions: Although IM interns had favorable attitudes toward video and phone visits, few had training or clinical experience; most felt unprepared. Residency programs may need to close training gaps for current interns in conducting telehealth video and phone visits.

Introduction Burnout is prevalent among medical trainees and faculty. Resilience, the ability to cope well with stress and thrive during challenges, has been a focus of initiatives to combat burnout. However, curricula teaching resilience skills are needed. Since residents experience challenging and stressful clinical events often, and would like to discuss these events with their teams, resilience skills may help trainees cope after such events. Additionally, resilience skills may help trainees address other challenges they face as team leaders. Leadership training is an important component of physician professional development. Methods This advanced resilience training curriculum consists of two interactive workshops that include didactics, skills practice, and reflection. The first workshop focuses on applying resilience skills to team leadership, while the second focuses on structured team debriefing after difficult clinical events. This curriculum is intended for learners who are health care team leaders, such as senior residents, fellows, or faculty. It may be used with learners who have completed introductory resilience training or with those without prior training. Results The curriculum was rated highly by senior residents, who reported feeling more comfortable leading their teams after difficult clinical events and talking about these events following this curriculum. The majority of residents thought the workshops should be continued. Discussion This novel curriculum teaches learners to apply resilience skills during team leadership and difficult clinical scenarios. It was well received by senior residents and may be used with a variety of learners across health professions and training levels.

BACKGROUND: Internal medicine (IM) residency graduates consistently report being less prepared for outpatient practice than inpatient medicine. Although an initial study suggested interns arriving for IM residency reported low levels of preparedness for continuity clinic, the impact of education and experience during the undergraduate medical education to graduate medical education transition on ambulatory training is unclear. OBJECTIVE: To describe end of medical school primary care exposure among entering IM interns and its association with self-assessed preparedness for residency continuity clinic. DESIGN: Cross-sectional survey of 161 entering IM interns in 2019. PARTICIPANTS: Entering interns at four geographically diverse IM residency programs (